Neikrug Ariel B, Cho Shreya S, Nguyen Ethan S, Stehli Annamarie, Huo Shutong, Garcia Careesa, Au Stephanie, Masoumirad Mandana, Cant Wendy, Le-Bucklin Khanh-Van, Gagliardi Jane P, Xiong Glen L, McCarron Robert M
Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA.
Program in Public Health, University of California Irvine, Irvine, CA, USA.
J Gen Intern Med. 2025 Jan;40(1):102-112. doi: 10.1007/s11606-024-09020-1. Epub 2024 Oct 31.
Inadequate access to behavioral health services disproportionately impacts marginalized populations who live in disadvantaged areas. To reduce this gap, programs dedicated to optimizing behavioral health education and training must focus their efforts to enroll providers who practice in these disadvantaged areas.
The Train New Trainers (TNT) fellowship program aims to enhance behavioral health knowledge, skills, and attitudes of primary care providers (PCPs) who deliver care in disadvantaged communities. We evaluate the effectiveness of the TNT recruitment strategy and the use of scholarships for targeting and recruiting PCPs who practice in disadvantaged communities.
Observational study.
TNT fellows from 2016 to 2023.
State/federal classifications of medically underserved counties were used to establish scholarship criteria. Area Deprivation Index (ADI) was utilized to provide criterion validity for the use of state/federal criteria in the recruitment strategy, and to evaluate the effectiveness of the program in successfully recruiting PCPs practicing in disadvantaged communities.
Practice location data were available for 347 fellows, 88.8% of whom received scholarships. Of the 347 practices, 300 (86.5%) primarily served communities meeting at least one state or federal criterion for medical shortage areas and/or underserved areas. According to ADI scores, 32.3% of practices served areas classified in the highest ADI (ADI decile 9 or 10), with a progressive increase in the proportion of fellows practicing in underserved areas each year; in 2023, 89.9% of practices met federal shortage criteria and 40.5% served areas with the highest deciles of ADI.
The TNT program strategy for recruiting PCPs from high medical need geographical areas is associated with bringing primary care psychiatry education to areas considered underserved and disadvantaged. Equipping PCPs practicing in underserved areas with enhanced knowledge and skills in behavioral medicine has the potential to significantly improve the existing access gap in disadvantaged communities.
获得行为健康服务的机会不足对生活在贫困地区的边缘化人群产生了不成比例的影响。为了缩小这一差距，致力于优化行为健康教育和培训的项目必须集中精力招募在这些贫困地区执业的提供者。
“培训新培训师”（TNT）奖学金项目旨在提高在贫困社区提供护理的初级保健提供者（PCP）的行为健康知识、技能和态度。我们评估TNT招募策略以及使用奖学金来定位和招募在贫困社区执业的PCP的有效性。
观察性研究。
2016年至2023年的TNT奖学金获得者。
使用州/联邦对医疗服务不足县的分类来确定奖学金标准。利用地区贫困指数（ADI）为在招募策略中使用州/联邦标准提供标准效度，并评估该项目成功招募在贫困社区执业的PCP的有效性。
有347名奖学金获得者的执业地点数据，其中88.8%获得了奖学金。在这347个执业地点中，300个（86.5%）主要为符合至少一项州或联邦医疗短缺地区和/或服务不足地区标准的社区提供服务。根据ADI分数，32.3%的执业地点服务于ADI最高的地区（ADI十分位数9或10），每年在服务不足地区执业的奖学金获得者比例逐渐增加；2023年，89.9%的执业地点符合联邦短缺标准，40.5%的执业地点服务于ADI十分位数最高的地区。
从医疗需求高的地理区域招募PCP的TNT项目策略与将初级保健精神病学教育引入被认为服务不足和贫困的地区相关。为在服务不足地区执业的PCP配备行为医学方面增强的知识和技能，有可能显著改善贫困社区现有的服务差距。
Zotero 插件
